dc.contributor.author |
López Varela, Elisa |
dc.contributor.author |
Fuente Soro, Laura |
dc.contributor.author |
Augusto, Orvalho |
dc.contributor.author |
Sacoor, Charfudin |
dc.contributor.author |
Nhacolo, Ariel |
dc.contributor.author |
Karajeanes, Esmeralda |
dc.contributor.author |
Vaz, Paula |
dc.contributor.author |
Naniche, Denise |
dc.date |
2019-02-20T15:56:52Z |
dc.date |
2019-02-20T15:56:52Z |
dc.date |
2018-08-01 |
dc.date |
2019-02-14T15:50:55Z |
dc.identifier.citation |
1525-4135 |
dc.identifier.uri |
http://hdl.handle.net/2445/128568 |
dc.format |
9 p. |
dc.format |
application/pdf |
dc.language.iso |
eng |
dc.publisher |
Lippincott, Williams & Wilkins |
dc.relation |
Reproducció del document publicat a: http://dx.doi.org/10.1097/QAI.0000000000001720 |
dc.relation |
Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 2018, vol. 78, num. 5, p. 527-535 |
dc.relation |
http://dx.doi.org/ 10.1097/QAI.0000000000001720 |
dc.rights |
cc by-nc-nd (c) López Varela, 2018 |
dc.rights |
info:eu-repo/semantics/openAccess |
dc.rights |
http://creativecommons.org/licenses/by-nc-nd/3.0/es/ |
dc.subject |
VIH (Virus) |
dc.subject |
Moçambic |
dc.subject |
HIV (Viruses) |
dc.subject |
Mozambique |
dc.title |
Continuum of HIV Care in Rural Mozambique: The Implications of HIV Testing Modality on Linkage and Retention |
dc.type |
info:eu-repo/semantics/article |
dc.type |
info:eu-repo/semantics/publishedVersion |
dc.description.abstract |
INTRODUCTION: Context-specific improvements in the continuum of
HIV care are needed in order to achieve the UNAIDS target of
90-90-90. This study aimed to assess the linkage to and
retention in HIV care according to different testing modalities
in rural southern Mozambique. METHODS: Adults newly diagnosed
with HIV from voluntary counseling and testing (VCT),
provider-initiated (PICT) and home-based HIV testing (HBT)
services were prospectively enrolled between 2014- 2015 at the
Manhica District. Patients were passively followed-up through
chart examination .Tracing was performed at 12-months to
ascertain causes of loss to follow-up. Fine and Grey competing
risk analysis was performed to determine factors associated with
the each step of the cascade. RESULTS: Overall linkage to care
as defined by having a CD4 count at 3 months, was 43.7% (95CI%
40.8-46.6) and 25.2% of all participants initiated ART. Factors
associated with increased linkage in multivariable analysis
included testing at VCT, older age, having been previously
tested for HIV, owning a cell phone, presenting with WHO
clinical stages III/IV, self-reported illness-associated
disability in the previous month , and later calendar month of
participant recruitment. Ascertaining deaths and transfers
allowed adjustment of the rate of 12-month retention in
treatment from 75.6% (95% CI 70.2-80.5) to 84.2% (95% CI
79.2-88.5). CONCLUSIONS: HBT reached a socio-demographically
distinct population from that of clinic based testing modalities
but low linkage to care points to a need for facilitated linkage
interventions. Distinguishing between true treatment defaulting
and other causes of loss-to-follow-up can significantly change
indicators of retention in care. |